[Orbital epidermoid cyst. Case report]

[Epidermoid cyst in the sella turcica: about a case]

Le kyste épidermoïde (KE) ou cholestéatome est une tumeur bénigne d'origine souvent congénitale, survenant dans les espaces sous-arachnoïdiens, son traitement est principalement chirurgical. Nous rapportons le cas d'un patient, âgé de 38 ans, qui a présenté d'une façon progressive, un syndrome d'hypertension intracrânienne, associé à des signes d'insuffisance antéhypophysaire des axe corticotrope, thyréotrope et gonadotrope installés depuis 1an et chez qui l'IRM cérébrale a été en faveur d'un craniopharyngiome, avec révélation de kyste épidermoide sur pièce anatomo-pathologique.

Uncommon presentation of an intradiploic orbital epidermoid tumor: case report

PURPOSE

Epidermoid tumors are uncommon entities that usually occur intradurally in the cerebellopontine angle and parasellar cisterns. The few cases that have been reported to occur in the intraorbital location involve patients in the first four decades of life. To our knowledge, an elderly person presenting with an orbital epidermoid tumor has never been reported.

METHODS

A 67-year-old man presented with left-sided headache and eye pain. He was found to have a hemorrhagic lesion eroding bone of the greater and lesser wings of the sphenoid that was compressing the frontal and temporal lobes and displacing the globe. Significant edema of the frontal lobe was noted.

RESULTS

Aggressive surgical excision was performed with cranioplasty and orbital reconstruction. Near resolution of the patient's proptosis and eye pain was achieved. Histologic analysis revealed the lesion to be an epidermoid tumor.

CONCLUSIONS

Hemorrhage into a growing intradiploic orbital epidermoid and surrounding frontal lobe edema created an unusual presentation of this rarely occurring entity in an elderly man. Surgical excision allowed appropriate histologic diagnosis and resolution of symptoms. Epidermoid tumor is a rare but possible entity in the differential diagnosis of elderly patients presenting with acute ocular pain and proptosis.